Immature platelet fraction measured on the Sysmex XN hemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation

Abstract

ObjectivesA period of thrombocytopenia is common after stem cell transplantation (SCT). To prevent serious bleeding complications, prophylactic platelet transfusions are administered. Previous studies have shown that a rise in immature platelets precedes recovery of platelet count. Our aim was to define a cutoff value for immature platelets predicting thrombopoietic recovery within 2 d.MethodsHematological parameters were measured on the Sysmex XN hemocytometer. We calculated reference change values (RCV) for platelets in eight healthy individuals as marker for platelet recovery. To define a cutoff value, we performed ROC analysis using data from 16 autologous SCT patients.ResultsRCV for platelet concentration was 14.1%. Platelet recovery was observed 13 (median; range 9–31) days after SCT. Increase in immature platelet fraction (IPF) before platelet recovery was seen in all autologous SCT patients. Optimal cutoff IPF was found to be 5.3% for platelet recovery within 2 d (specificity 0.98, sensitivity 0.47, positive predictive value 0.93).ConclusionsWe identified an optimal cutoff value for IPF 5.3% to predict platelet recovery after autologous SCT within 2 d. Implementing this cutoff value in transfusion strategy may reduce the number of prophylactic platelet transfusions.

Determinants of platelet count in pediatric patients with congenital cyanotic heart disease: Role of immature platelet fraction

“…16 To determine the pathogenesis of thrombocytopenia, platelet production was determined by assessment of IPF as previously reported. 17 We found higher IPF levels in CCHD patients with thrombocytopenia compared with the nonthrombocytopenic group suggesting increased platelet production among those patients. Elevated IPF levels among our CCHD patients with thrombocytopenia mean the absence of central marrow pathology and the significant negative correlations between the platelet count and each of IPF and PT make the likelihood of peripheral platelet destruction and/or platelet activation a higher possibility.…”

Clinical significance of IPF% measurement in diagnosing thrombocytopenic disorders: distinguishing primary immune thrombocytopenia from other disorders

“…Sysmex XN is provided with new PLT-F channel that can determine platelets and IPF as a percentage using different reagents and method from previous analyzers [3,8,13]; The main advantage of this new channel over the PLT-O method is the ability to identify apoptotic white cells in samples and not include them as platelets [8,13,15].…”

“…Sir, Platelets are megakaryocytic small fragments circulating in blood [1,2]. The reference value rate in adult humans is between 150 and 350 9 10 9 /L [3,4]. Thrombocytopenic disorders may be due to several causes, essentially divided into three main situations: (i) abnormal platelet distribution caused by dilution, bleeding or splenomegaly, (ii) high platelet destruction and (iii) inadequate platelet production.…”

“…Thrombocytopenic disorders may be due to several causes, essentially divided into three main situations: (i) abnormal platelet distribution caused by dilution, bleeding or splenomegaly, (ii) high platelet destruction and (iii) inadequate platelet production. [3,5].…”

“…[7,9,10,11]. Measure of immature platelet fraction (IPF) has been suggested as a less invasive and early diagnostic test in the study of thrombocytopenic disorders [3,5,8].…”